Thursday, January 25, 2007

PEP

A friend (Guinnie, can I call you a friend?? After all, I have only laid eyes on you once, but you do know more about my thoughts & actions than is probably sensible considering.) has asked before for me to do an informative post on an important aspect of HIV Awareness:What to do should you have been exposed to the HI virus.Through sex, through accidental exposure to blood through care & treating.

I usually simply refer to this topic as PEP – Post Exposure Prophylaxis.This is an emergency medical response for a person exposed to HIV. It consists of counselling, lab tests, and medication. It lasts for 4 weeks.

I only know this topic in theory, so maybe some people will comment about the practical reality of it all…

PEP Starter Packs are supposed to be available at all heath care services and some police stations (Phone 10111). Demand it if you have been raped or sexually assaulted. It is your legal right. You will need to start treatment as soon as 2 hours and as delayed as 72 hours after the incident. Obviously the sooner you start, the more chance you will have of not becoming infected with HIV.

At these places they will give you a STARTER PACK. This pack is designed to provide medication for only the first 3 days, because it is designed as an emergency measure. The course of medication, however, needs to last for 4 weeks. So you will need to visit a doctor or a clinic to obtain the follow-up medication.

In South Africa, rape survivors are provided with free ARV (antiretroviral) drugs at state hospitals & some clinics. Phone the AIDS Helpline (0800 012 322) should they not be available at the place you visit, to find out where they can be freely obtained. ART (ARV Treatment) is also available at chemists, but a prescription is needed and then they are not free.

A combination of AZT & 3TC is usually recommended for a period of 28 days. In higher risk situations (the other person is known to be HIV+ or where considerable trauma & bleeding is evident) the treatment may include more – a doctor would advise you on this. Should the exposure have been through sex, treatment should also include treatment against Sexually Transmitted Diseases (STDs) and the morning-after pill (medicine used to prevent pregnancy).

You should be counselled and tested for HIV before the treatment is started.If you test positive immediately, you will not be given ART (ARV Treatment) as you were infected prior to the incident & so it will be ineffective. If you must wait for the test results of the HIV test, you should start being treated immediately, and continue until you know if you were positive or negative before the incident.

You must be counselled on the side effects of the treatment. I do know that one type of ARV used can cause diarrhoea, fever, inflammation of the liver, muscle pain, dizziness, headaches, loss of appetite, nausea, fatigue, insomnia and vomiting. Very rarely, more serious side effects can occur – just keep your doctor up-to-date on your situation. This drug’s combination with the Morning-After pill is likely to cause sever nausea.

There are (expensive) tests available through doctors that can tell your HIV status within days after infection.

After the 4 week course of treatment, you will need to go for HIV tests at 6 weeks, 3 months, and 6 months after the incident, and even at one year to be 100% certain of your HIV status. You must practice safe sex for 6 months after the incident.

You should visit a psychologist or a counsellor to address the psychological trauma you have suffered through the incident.Please also report the rape or sexual assault to the police.

The sooner you start on this course, the better. The ARVs interfere with the replication mechanisms of HIV and prevents the virus from reproducing. Unfortunately ART (ARV Treatment) does not always succeed in preventing HIV from infecting a person. But it is your best hope at the moment.

Some international companies store their own PEP packs, readily available to their employees & dependants, who were exposed through rape, sexual assault, or accidents through work-related activities. You can discuss such a possibility with your employers, and instate it through your company’s HIV Workplace Policy.

Children who have been sexually assaulted or raped can take antiretroviral drugs – dosages will be adjusted to the child’s weight. Children older than 14 years do not need their parents’ or guardians’ permission to have an HIV test or to take ARV medication.

As for The Morning-After Pill – one tablet is taken within 72 hours of exposure, and a second tablet is taken 12 hours after the first tablet. This medication is likely to cause severe nausea.

PLEASE use this information sensibly. As seems to distressingly happen with the morning-after pill these days, some people think that these measures can be used as a substitute for contraception. PEP is to be used with care and should not be used routinely or frequently in place of general safer sex practices. Misuse of this treatment can make you resistant to future treatment.

Basically - Do not mess around with ARVs & PEP!

I hope that you never have to remember or use this information!

Now I have a hangover to nurse with food from the darling Sandwich Lady, and a friend to convince to go on a date I was party to establishing when we met an eligible bachelor as we got nicely sozzled over much white wine last night.

Question:"After the 4 week course of treatment, you will need to go for HIV tests at 6 weeks, 3 months, and 6 months after the incident, and even at one year to be 100% certain of your HIV status. You must practice safe sex for 6 months after the incident."

If you can only be 100% certain at one year howcome practise safe sex for only 6 months?

Or you could use a condom correctly & consistently. You could ensure that your future sex partners are HIV negative before you guys start at it like rabbits, while (somehow) ensuring you AND they stay faithful.

Or buy a blowup doll.

Yeah, careful how you tease & mock the host of this site! ....also, maybe just try mock me after next week!

The 3 month test should be just out of the window period (when the virus might still be undetectable in your body), so the 6 month test is an extra-precaution. The year test is more like a psychological thing, giving you complete peace of mind & closure to the incident.

While this virus & other STDs plague us, you should always practice safe sex actually! In whatever way you choose that should be.

LoL - there are certain rules in life that clever people follow. 1. Always wrap your tool. 2. go for HIV tests, as scary as they seem. 3. Always wrap your tool. There is no way I can be celibate again. Never. What am I gonna read while you're away... *sniff

Champs this is something that has been plaguing me now for some time...I really do start off every year having an HIV test as well as a full STI test. I don't know why, it's just a thing I do.I have to tell you it really peeved me off this year that I couldnt just walk into the lab, ask for the test, have it, go home and wait for the results.

I had to get a consultation, so that the doctor could write up the bloodwork request. He of course wanted to know when this happened - that was his actual question to me. Firstly "it" didnt ever happen and secondly if "it" did why would "it" be any of his business?

What "it" was we can only assume... a rape incident I dunno...The point is it shouldn't be such a hassle for something like this - especially in this country.

Sorry god I really did have a rant there. Seems I'm still quite mad about this.

Phlippy - you are only up to Part 4 now!!! How long will I be having to wait in this frustration!?!? Actually, the arrival of a certain aeroplane is hopefully more likely to get me laid, but that story is not meant to be divulged. He he he.

Anyway....

Muddle - I think what you are wondering is why can't we just get blood tests at our own discretion? Why can't we just stroll into Lancet & hold out a vein. (or can we?? Where are my doc mates when I need them??). That I am not certain of. I will try to find out for you.

By law in SA you need to have counselling before & after HIV testing, probably what your doc was poorly attempting there. He is meant to make you aware of the risks you are putting yourself in, helping to change your behaviour to low/no-risk, make you aware of the basics of HIV, and prepare you for the shock & trauma should you be positive, as well as help to guide you towards positive next steps.

I completely agree with this counselling being vital, as many many S.Africans are ignorant to HIV & if not aided, will end up being a danger to themselves, their families & others - and also to the state & our systems & resources. So while, yes, we need to be churning out people with their status, we also need to be sensitive to this delicate controversial overwhelming situation.

If "it" was a rape incident that your doc was referring to, I would hope that he would've been more sympathetic & sensitive. I think he was simply referring to having sex in general. Docs are known to give some useless attempt at counselling.

Good for you for going every year for those tests!! I think it is excellent. And perhaps use his future odd questioning as a means for reflection of your lifestyle choices & possible risky behaviour. Or change to a doc who asks better questions, or who forgoes the entire dicussion part of it.

It's a term used to alliterate the sound of crickets tat one would here when they say something and everyone goes quiet. :-) I must tell you though, I no longer have an accent, it only comes backwhen I spend an extended period in France. That last happened in 1998/1999

Phlippy - how about if you hang around Frenchies?? I know some frenchies in town. And some frenchies coming to visit SOON. Hell, I start speaking like a frenchie as soon as just think "French"! It's a side effect of being a francophile.

[MEANWHILE!!! I would like to say this right now cause of a recent moment in my life - FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFRRRRRRRRRRRRRRRRRRRRRCCCCCCCCCCCCCCCCCCCCCCCCCCKKKKKKKKKKKKKKKKKKKKKKKKKING MEN!!! Men, I am SICK of. Someone take me to an Adultworld & then buy me a hermit hut. I'ma gettin' out this here game!]

Damnit... you're going to have a fun weekend :-) Like that chick that was wearing the underwear and fainted in the shop from too many orgasms. Paramedics had to take the still vibrating underwear off her before resuscitating her

Champers, love the good work you are doing to educate us Bloggers about HIV and PEP and ARVs and stuff. Why isn't the government actively marketing this information to the nation when we have the highest HIV infection statistics in the world?!?!

Sorry to get serious there for a mo, but I wish that "educated" people wouldn't consider themselves exempt from the life-changing events which could occur from a quick romp in the hay with George from Accounts. (No Phlippy, that is not my name for my willie). And considering how promiscuous our society is getting, this is really scary! I know ladies who have bedded over 30 men...and think this is normal? Dang wish I was having that much sex! (Or any sex. And sex by yourself isn't what its cracked up to be).

Phlippy - I wonder if those underpants come in the starter pack?!?!? I hope so! And I am going to have one fun LIFETIME there in the Maluti mountain hermit hut!

Wiggly - they are marketing it to certain sectors. Not that those certain sectors have the infrastructure in place to manage the plans accordingly. Like taking a kid to a clinic in Orange Farm after she has just been raped & getting a doc to pay attention is difficult enough, let alone getting PEP packs from them! (Actually, with that story, I was told by the teacher who took the girl to the clinic, that no one at the clinic ever paid them enough attention during their several hours wait & begging & pleading, so they were just forced to leave.Fck it.)

Yeah, the gov is not showing too much concern for its richer whiter sectors. So I am stepping in with my little blog and ribbon badge and big loud mouth.

No worries about being serious. It is meant to be a serious post, provoking serious thoughts.

As for knowing women who have bedded many a man, as long as you wear a condom when it's your turn and/or go for a HIV test with them, when both you & they are out of the window period, before starting sexual relations.

Or be single & forever celibate like me. I will not take your word on this self-loving aspect, but should I not stay in the Maluti mnts, with my AdultWorld Starter Pack, then you can know that you were right!

I don't know wbaout the starter pack, but I did get a massage machine from Germany for Christmas which vibrates quite hecticly with 4 different interchangeable heads. I'm starting to seriously wonder about the 'validity' of it massage powers and more on the other uses it may have...

When i told the doc I wanted to go for an Aids and full STI test he looked at me and said "ok. so when did it happen?"Like I said one can only assume what the "it" was that he was particularly referring to.

I can answer the question for you:NO. One cannot just walk into Lancet and request these tests.My beef is not the counselling aspect as i said i agree.My beef is, when it comes to this testing, particularly in this country, it should not be a deterrent in any way

wow who knew.. iv always heard that if you got raped or assaulted or something that you only had to take the arv's when you get to the cop shop and that was the end of it... im definatly mailing this all the women i know, some nifty advice Champs.